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Ambetter Health Billing Code Update for CPT Codes 80320-80377 Effective 10/01/2026
Act
by Sep 30, 2026
Effective date
Oct 1, 2026
Identified
Aug 26, 2026
Summary
Effective October 1, 2026, Ambetter Health will no longer reimburse CPT codes 80320-80377 (Definitive Drug Testing Procedures). Billing teams must transition to G-series bundled laboratory codes for these services to avoid claim denials.
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What to do
by Sep 30, 2026 · 5 steps
01Billing team must update billing software to discontinue reimbursement claims for CPT codes 80320-80377 under Ambetter Health plans.
02Identify all drug testing procedures currently billed with these codes and map them to appropriate G-series bundled laboratory codes.
03Update all encounter templates, charge masters, and billing rules to automatically route drug testing claims to G-series alternatives for Ambetter Health.
04Audit pending claims for October 1, 2026 forward to prevent denials.
05Contact Ambetter Health Provider Relations with questions about specific code mappings.
Codes mentioned
80320803218032280323803248032580326803278032880329803308033180332803338033480335803368033780338803398034080341803428034380344803458034680347803488034980350803518035280353803548035580356803578035880359803608036180362803638036480365803668036780368803698037080371803728037380374803758037680377
Original notice
Ambetter Health Billing Code Update for CPT Codes 80320-80377 Effective 10/01/2026
ambetterhealth.com · Always check the source before changing claims.
Related changes
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